1 Guidance

1 Guidance

This document together with the guidance published on autologous pancreatic islet cell transplantation for improved glycaemic control after pancreatectomy (IPG274) replaces previous guidance IPG013 on pancreatic islet cell transplantation.

1.1 The evidence on allogeneic pancreatic islet cell transplantation for type 1 diabetes mellitus shows short-term efficacy with some evidence of long-term efficacy. The evidence on safety shows that serious complications may occur as a result of the procedure. The long-term immunosuppression required is also associated with a risk of adverse events. In units with established experience in allogeneic pancreatic islet cell transplantation, the procedure may be used with normal arrangements for clinical governance (see also section 2.5.2).

1.2 During consent, clinicians should ensure that patients understand the potential complications of the procedure and the uncertainty about its efficacy in the long term. They should provide patients with clear, written information. In addition, use of the Institute's information for patients ('Understanding NICE guidance') is recommended.

1.3 Patient selection for this procedure should involve a multidisciplinary team. Selection criteria should take into account that the procedure is particularly indicated for patients with hypoglycaemia unawareness and/or those already on immunosuppressive therapy because of renal transplantation.

1.4 Further audit and research should address the effect of the procedure on quality of life and its long-term efficacy, particularly in relation to the complications of diabetes (see section 3.1).